Clinical Oncology

[Fatigue - symptom or side effect]

TOKODI Zsófia

FEBRUARY 10, 2018

Clinical Oncology - 2018;5(01)

[Cancer-related fatigue (CRF) is common in most cancer patient, which has a high impact on the quality of their life. It affects not only the patient itself, but also their families and relationships. It is the most underreported, overlooked and undertreated symptom. The screening and adequate treatment of CFR is getting more attention nowadays and it became the subject of guidelines of several international expert groups like the ASCO) and the NCCN. In this review we would like to summarize the contributory factors of CRF, the screening methods, the clinical assessment and the interventions of patients with cancer related fatigue. We try to give guidance to distinguish fatigue as a symptom of disease progression or as a side effect that we can treat. But lastly the most important question becomes that why CRF is so underreported.]

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Clinical Oncology

[Foreword]

A szerkesztők

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[New results from San Antonio Breast Cancer Symposium, 2017]

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[SABCS 2017 has been a 40-year jubilee conference with festive appearance and content. The anniversary provides possibility to look back: today we fi nd the knowledge and practice as of twenty years ago schematic and rough while the changes are overwhelming. Therapy became colorful and personally. There is need for precisious care which means consideration all patient and tumor features when surgical or medical therapy, radiotherapy or even diagnostic issues are decided - this has been the most important message of the conference this year. The Symposium always provides the most modern and breakthrough approaches and attitude that support advancement in patient care.]

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VÉGSŐ Gyula, MÁTHÉ Zoltán

[Recent breakthroughs in the fi eld of organ transplantation and oncology have challenged existing views, and necessitate the revision of several tumor-related issues in transplantation. The need for expanding the donor pool raises the question of how and when it is plausible to transplant the organs of a donor with a history of cancer, such that the risk of tumor inoculation and manifestation due to the graft would be minimal for the recipient. Another point to consider is whether it is acceptable to transplant a recipient with a history of a malignant tumor, and if yes, how much tumor-free survival time is required as a minimum before the transplant. Transplanted patients live longer as a result of modern immunosuppressive therapy. However, the risk of malignant tumors increases proportionally to the length of the immunosuppressed state: their incidence may be as much as 20-30% in the long term. The signifi cance of „de novo” posttransplant tumors is highlighted by the fact that they are among the leading causes of death in transplant patients. Taken together, malignant diseases pose a serious problem from several aspects, the solution for which requires close teamwork of experts in oncology and transplantation, and the integration of up-to-date knowledge in the process of making a therapeutic decision, tailored individually for the patient.]

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[EMT (Epithelial-Mesenchymal transition) – CSC (Cancer Stem Cells)]

KOPPER László

[The effi cacy of the antitumor therapy is usually limited due to the resistance against the chemotherapy. One of the most important reason of the secunder resistance is the intratumoral heterogeneity, which is the consequence of the variety tumor phenotypes in the same tumor. Such clonal heterogeneity develops during the tumor growth or tumor therapy. The cancer stem cells (CSC), according to the concept, can determine the progression of the tumor, including metastatization, which probably the major enemy for clinical oncology. This activity of CSC, in tumors with epithelial origin, is supported by a change from epithelial to mesenchymal phenotype (epithelial-mesenchymal transition); but not entirely. The CSC phenotype is very similar to characteristic of the normal stem cells, as resistance, self-renewal etc. The mechanisms of these concepts is known only partially, but the technical advances contribute to the identifi cation of key genetic and epigenetic regulatory pathways. If such improvement becomes real, we can be much ahead both with markers and therapeutic targets.]

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